Critical Reasons you Need Revenue Cycle Management System for Optometry Practices

Certified medical billers and coders stand to be the backbone of your Revenue Cycle Management (RCM), as they are the experts that enhance your income cycle. Letting the professionals of finances take over your RCM cycle is a blessing in disguise, as it frees your time to check for patients with eyesight issues.

While looking for reasons as to why you need the partnership of a billing organization: Are you getting your money’s worth with your in-house billers or billing service for your eye care practice?

Remember that choosing the medical billing service is more than just finding someone to process claims. If you are considering outsourcing your ophthalmology medical billing service, and are still in dilemma about making the leap, here are eight reasons to help you decide.

In a basic explanation revenue cycle management (RCM) can be defined as the process of handling healthcare insurance claims, processing payment and generating revenue for a medical practice, ASC, outpatient facility and also a hospital. It begins just at the time when a patient makes an appointment and continues until the balance on his account becomes nil. It includes various steps like checking patient insurance eligibility and coding claims.

Advantages of Having a Revenue Cycle Management Organization for assistance

  • A well-designed RCM system trails patient care, streamlines the billing and collection cycles, by registering, appointing, scheduling and processing the payment.
  • With the help of RCM, collaborating with the EHR and accounting systems becomes easier.
  • Revenue cycle management associates administrative documents like a patient’s name, insurance provider and other personal information along with the treatment received by a patient.
  • It bridges the gap between the business and healthcare sides of healthcare.
  • Healthcare providers also take help from revenue cycle management experts for preserving and managing patients’ billing records.
  • It diminishes the time between offering a service and receiving payment for it by interacting with other health IT systems like electronic health record systems and billing systems.
  • It empowers the RCM system to perform duties routinely. As this was previously handled manually employees, software support systems have been able to save healthcare practices time.
  • RCM is responsible for all administrative tasks including informing patients of an upcoming appointment, reminding payers and patients of an existing balance and questioning insurers, when a claim is denied.
  • It saves the money of Optometrists by reducing the amount of denied claims and enabling patients to pay their bills online.
  • It allows the in-house staff to enter all the information required for claims processing and management and avoids the revision or resubmission of claims.
  • With the help of specialized RCM billers, an organization can buy analyze the income cycle operation in real-time and use dashboards to determine or analyze revenue goals.
  • Aligning with the experts’ aides Optometry facilities to check where its revenue cycle has the scope of improvement by arranging billing data and producing corresponding reports.

The RCM Workflow

Communicating with health insurance providers is another critical aspect of revenue management. When a patient books an appointment, the healthcare center typically checks the patient’s described insurance coverage before the visit.

After an insured patient gets diagnosed, he supplies applicable copay. A healthcare provider or coder classifies the nature of the treatment as per the ICD-9 or ICD-10. The hospital submits the care summary with ICD and Current Procedural Technology codes to the patient’s insurance firm to see the procedure of treatment covered by insurance.

The revenue cycle management (RCM) system can make or break a hospital or physician practice. Hence, Revenue cycle management should be selected very wisely.